By Katrina Kuzyszyn-Jones
What do we know about chronic pain? It’s expensive, difficult to manage and compounded by depression, anxiety and substance use. Chronic pain affects 100 million Americans and affects more people than heart disease, stroke, diabetes and cancer combined. We know that medications do not work, are addictive, and we need alternative solutions.
Acute pain is related to an injury. Chronic pain IS the problem, not a symptom of a problem. It may be
labeled as the area in which it occurs (back, neck) OR something that is more diffuse or vague like IBS or fibromyalgia.
The problem with chronic pain is that there isn’t an area that can be “fixed” because it’s actually a brain
issue. And, chronic pain is contributed to and complicated by social economics, family situations, stress, biological predisposition, emotional well-being, and the conceptualizing of pain (i.e. sensation versus pain). It’s also not just about the pain – it leads to fatigue, feeling lousy, behavioral changes, depression, anxiety and risk of substance misuse.
So, where does yoga fit in? Although movement can be painful when one has chronic pain, it is still necessary. Rather than encouraging people to exercise, yoga encourages mindful movement. movement in yoga practices increases blood flow, releases endorphins, improves concentration, self-regulation and control, and promotes mindfulness. Breathing is also a highly important component of yoga. Breathing directly affects systems in the body that help produce feelings of calm and reduce pain and fear.
Yoga and other mindfulness practices encourage the development of grey matter in the brain, which increases pain tolerance. In addition, yoga helps us redefine our relationship with pain. Yoga helps through re-framing and cognitive appraisal. It also encourages the use of imagery. Yoga helps our bodies develop a relaxation response (muscles needs to relax to stretch and strength). Mindful movement helps us learn to pace activities and be more aware of our bodies and what we need.
How do we integrate yoga into therapy? Mindfulness exercises can help us rename pain as sensation. We can learn to visualize doing something without pain or with less pain. We can rewire the brain by noticing what feels good in some parts of the body that are not in pain. You don’t have to do headstands or wrap your legs around your head to do yoga. For chronic pain, you don’t need big movements. You can practice ankle rolls, wrist rolls, neck movement – and then you notice where your body is in space, what it’s feeling, and that you can disconnect from the pain.
If we can develop a friendly relationship with pain, we can also decrease stress, improve our functional
living, and experience improved overall health and mental well-being. The key is not to practice mindfulness or yoga with the intention of not feeling pain. The goal is to change your relationship to the
pain. Where do you feel the sensation? Where is it absent? Can you feel some spaciousness? Can you experience relaxation and pain at the same time?
You also don’t have to do this for long periods of time. If you can practice 10-20 minutes a day, it can
help with sleep disturbance and have other positive benefits. However, you can also do one minute,
three minutes, close your eyes at your desk, etc. Then, notice your posture. You can make movement
changes. You can do one small stretch.
The bottom line is that you are not your pain. It hurts, but it doesn’t have to define who you are.
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